A new way of monitoring mechanical ventilation by measurement of particle flow from the airways using Pexa method in vivo and during ex vivo lung perfusion in DCD lung transplantation
(2018) In Intensive Care Medicine Experimental 6(1). p.1-19- Abstract
BACKGROUND: Different mechanical ventilation settings are known to affect lung preservation for lung transplantation. Measurement of particle flow in exhaled air may allow online assessment of the impact of ventilation before changes in the tissue can be observed. We hypothesized that by analyzing the particle flow, we could understand the impact of different ventilation parameters.
METHODS: Particle flow was monitored in vivo, post mortem, and in ex vivo lung perfusion (EVLP) in six porcines with the Pexa (particles in exhaled air) instrument. Volume-controlled ventilation (VCV) and pressure-controlled ventilation (PCV) were used to compare small versus large tidal volumes. The surfactant lipids dipalmitoylphosphatidylcholine... (More)
BACKGROUND: Different mechanical ventilation settings are known to affect lung preservation for lung transplantation. Measurement of particle flow in exhaled air may allow online assessment of the impact of ventilation before changes in the tissue can be observed. We hypothesized that by analyzing the particle flow, we could understand the impact of different ventilation parameters.
METHODS: Particle flow was monitored in vivo, post mortem, and in ex vivo lung perfusion (EVLP) in six porcines with the Pexa (particles in exhaled air) instrument. Volume-controlled ventilation (VCV) and pressure-controlled ventilation (PCV) were used to compare small versus large tidal volumes. The surfactant lipids dipalmitoylphosphatidylcholine (DPPC) and phosphatidylcholine (PC) were quantified by mass spectrometry.
RESULTS: In vivo the particle mass in VCV1 was significantly lower than in VCV2 (p = 0.0186), and the particle mass was significantly higher in PCV1 than in VCV1 (p = 0.0322). In EVLP, the particle mass in VCV1 was significantly higher than in PCV1 (p = 0.0371), and the particle mass was significantly higher in PCV2 than in PCV1 (p = 0.0127). DPPC was significantly higher in EVLP than in vivo.
CONCLUSIONS: Here, we introduce a new method for measuring particle flow during mechanical ventilation and confirm that these particles can be collected and analyzed. VCV resulted in a lower particle flow in vivo but not in EVLP. In all settings, large tidal volumes resulted in increased particle flow. We found that DPPC was significantly increased comparing in vivo with EVLP. This technology may be useful for developing strategies to preserve the lung and has a high potential to detect biomarkers.
(Less)
- author
- Broberg, Ellen LU ; Wlosinska, Martiné LU ; Algotsson, Lars LU ; Olin, Anna-Carin ; Wagner, Darcy LU ; Pierre, Leif LU and Lindstedt, Sandra LU
- organization
- publishing date
- 2018-07-27
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Intensive Care Medicine Experimental
- volume
- 6
- issue
- 1
- pages
- 1 - 19
- publisher
- Springer
- external identifiers
-
- pmid:30054767
- scopus:85077050014
- ISSN
- 2197-425X
- DOI
- 10.1186/s40635-018-0188-z
- project
- Microvascular blood flow measurements with laser speckle contranst imaging in skin, lung and heart
- Monitoring mechanical ventilation using particles in exhaled air in lung transplantation, ex-vivo lung perfusion and surgical settings – a new technique-
- language
- English
- LU publication?
- yes
- id
- 3e20582d-9175-4eb4-a3f3-f8ead90b6415
- date added to LUP
- 2018-08-27 14:04:24
- date last changed
- 2024-09-21 01:04:14
@article{3e20582d-9175-4eb4-a3f3-f8ead90b6415, abstract = {{<p>BACKGROUND: Different mechanical ventilation settings are known to affect lung preservation for lung transplantation. Measurement of particle flow in exhaled air may allow online assessment of the impact of ventilation before changes in the tissue can be observed. We hypothesized that by analyzing the particle flow, we could understand the impact of different ventilation parameters.</p><p>METHODS: Particle flow was monitored in vivo, post mortem, and in ex vivo lung perfusion (EVLP) in six porcines with the Pexa (particles in exhaled air) instrument. Volume-controlled ventilation (VCV) and pressure-controlled ventilation (PCV) were used to compare small versus large tidal volumes. The surfactant lipids dipalmitoylphosphatidylcholine (DPPC) and phosphatidylcholine (PC) were quantified by mass spectrometry.</p><p>RESULTS: In vivo the particle mass in VCV1 was significantly lower than in VCV2 (p = 0.0186), and the particle mass was significantly higher in PCV1 than in VCV1 (p = 0.0322). In EVLP, the particle mass in VCV1 was significantly higher than in PCV1 (p = 0.0371), and the particle mass was significantly higher in PCV2 than in PCV1 (p = 0.0127). DPPC was significantly higher in EVLP than in vivo.</p><p>CONCLUSIONS: Here, we introduce a new method for measuring particle flow during mechanical ventilation and confirm that these particles can be collected and analyzed. VCV resulted in a lower particle flow in vivo but not in EVLP. In all settings, large tidal volumes resulted in increased particle flow. We found that DPPC was significantly increased comparing in vivo with EVLP. This technology may be useful for developing strategies to preserve the lung and has a high potential to detect biomarkers.</p>}}, author = {{Broberg, Ellen and Wlosinska, Martiné and Algotsson, Lars and Olin, Anna-Carin and Wagner, Darcy and Pierre, Leif and Lindstedt, Sandra}}, issn = {{2197-425X}}, language = {{eng}}, month = {{07}}, number = {{1}}, pages = {{1--19}}, publisher = {{Springer}}, series = {{Intensive Care Medicine Experimental}}, title = {{A new way of monitoring mechanical ventilation by measurement of particle flow from the airways using Pexa method in vivo and during ex vivo lung perfusion in DCD lung transplantation}}, url = {{http://dx.doi.org/10.1186/s40635-018-0188-z}}, doi = {{10.1186/s40635-018-0188-z}}, volume = {{6}}, year = {{2018}}, }